Pathophysiologically substantiated prophylaxis and treatment of reperfusion-reoxygenative syndrome at revascularization of the lower extremities in conditions of chronic critical ischemia

Authors

  • I. K. Venher I. Horbachevsky Ternopil State Medical University
  • O. B. Kolotilo Bukovinian State Medical University
  • S. Ya. Kostiv I. Horbachevsky Ternopil State Medical University
  • A. R. Vaida I. Horbachevsky Ternopil State Medical University
  • N. I. Herasemuk I. Horbachevsky Ternopil State Medical University

DOI:

https://doi.org/10.11603/2414-4533.2018.3.9443

Keywords:

applying atherosclerosis, reperfusion-reoxygenative syndrome, revascularisation

Abstract

The aim of the work: to improve the results of reconstructive operations on the aorta and major arteries under conditions of chronic critical ischemia of the lower extremities.

Materials and Methods. The work includes 56 patients with obliterating lesions of the aorta and arteries of the lower extremities of II, IIIA, IIIB, IV stages chronic arterial insufficiency.

For the prevention and treatment of the phenomena of no-reflow and reflow-paradox in the pre-operative period, a complex of proposed measures was implemented.

To diagnose the nature of the lesion of the arterial bed and the features of hemodynamic disturbances, indicators of ultrasound dopplerography, duplex scanning, X-ray contrast digital angiography were used. To obtain information on changes in capillary blood flow and arteriovenular blood flow, the method of laser doppler fluorometry was used.

By volume of revascularization patients are divided into two groups. Operative intervention in the 1st group of patients included single-stage aorto-bifermal bypass (14 observations) and one-sided aorto(ileo)-femoral bypass (8 observations).

The second group included 34 patients who in addition to atherosclerotic occlusion aorto/ilia-femoral segment revealed stenotic-occlusive process femoral-popliteal segment. Dynamic ultrasound monitoring of hemodynamic femoral-popliteal segment postoperative patients II gr. revealed a decrease in peak systolic velocity and resistive index, which was an additional indication for reconstruction of the femoral-popliteal segment.

Conclusions. Pathophysiologically grounded preoperative prevention and treatment of reperfusion-reoxygenative syndrome in revascularisation of the lower extremities under conditions of chronic critical ischemia, make it possible to prevent the development of postoperative complications.

References

1. Moller, E.R., & Djaff, M.R. (2010). Zabolevanie perifericheskikh arteriy [Diseases of peripheral arteries]. Moscow: GEOTAR-Media [in Russian].
2. Belov, U.V., & Stepanenko, A.B., (2009). Povtornye rekonstruktivnye operatsii na aorte i magistralnikh arteriyakh [Repeated reconstructive surgery on the aorta and main arteries]. Moscow: MIA [in Russian].
3. Nikulnikov, P.I., Bitsay, A.V., Ratushniyak, A.V., & Liksunov, A.V. (2013). Osobennosti khururgicheskoy taktiki pri mnogourovnevikh okkluzionno-stenoticheskikh porazheniyakh bedrenno-bertsovogo arterialnikh segmentov [Features of surgical tactics in multilevel occlusive-stenotic lesions of the femoral-tibial arterial segments]. Kharkivska khirurhichna shkola – Kharkiv Surgical School, 3, 148-151 [in Russian].
4. Marshalov, D.V., Petrenko, P.V., & Glushach, I.A. (2008). Reperfussionnyy sindrom – ponyatie, opredilenie, klassifikatsiya [Reperfusion syndrome – concept, education, classification]. Patologiya krovoobrashcheniye i kardiokhirurgiya – Pathology of Blood Circulation and Cardiosurgery, 3, 67-72 [in Russian].
5. Dick F., Li J., Girarud V.N., Kalka C., Schmidli J., & Tevaearai H. (2008). Basic control of reperfusion effectively protects against reperfusion injuryin a realistic rodent model of acute limb ischemia. Circulation. 118 (19), 1920-1928.
6. Kostiv, S.Ya. (2006). Korektsiya reperfusiinoho syndromu pry khirurhicnomu likuvanni patsiyentiv iz aterosklerotuchnoiu okliuziieiu aorto-klubovo-stehnovoho sehmentu [Correction of reperfusion syndrome in cases of chronic obstructive pulmonary disease atherosclerotic occlusion of the aorto-ilio-femoral segment]. Shpytalna khirurhiia – Hospital Surgery, 1, 36-40 [in Ukrainian].
7. Venher, I.K., Yakymchuk, O.A., Kostiv, S.Ya., & Adarbech, A.S. (2010). Systemna zapalna vidpovid u rozvutku reperfusiinoho syndromu pry rekonstruktsii aterosklerotychnoho urazhennia aorto-stehno-pidkolinnoho sehmentu [The system inflamation responce in development of reperfusion syndrome at reconstruction of the atherosclerotic ulceration of the aorto- ilio-femoral segment]. Visnyk Vinnytskoho natsionalnoho medychnoho universutetu – Bulletin of the Vinnytsia National Medical University, 1, 87-88 [in Ukrainian].
8. Dick, F., Li, J., Girarud, V.N., Kalka, C., Schmidli, J., & Tevaearai, H. (2008). Basic control of reperfusion effectively protects against reperfusion injuryin a realistic rodent model of acute limb ischemia. Circulation, 118 (19), 1920-1928.

Downloads

Published

2018-10-16

How to Cite

Venher, I. K., Kolotilo, O. B., Kostiv, S. Y., Vaida, A. R., & Herasemuk, N. I. (2018). Pathophysiologically substantiated prophylaxis and treatment of reperfusion-reoxygenative syndrome at revascularization of the lower extremities in conditions of chronic critical ischemia. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 75–80. https://doi.org/10.11603/2414-4533.2018.3.9443

Issue

No. 3 (2018)

Section

EXPERIENCE OF WORK

License

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Лицензия Creative Commons
  3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)